H5N1

MSF: Remain in Mexico policy leaves more than 1,500 asylum seekers stranded in border camp

Via Doctors Without Borders USA: Remain in Mexico policy leaves more than 1,500 asylum seekers stranded in border camp.

The Remain in Mexico policy, officially known as the US Migrant Protection Protocols (MPP), has left more than 1,500 vulnerable asylum seekers waiting in an informal camp at the international bridge between the violent border city of Matamoros, in Mexico’s Tamaulipas state, and Brownsville, Texas. 

Though latrines and showers have been installed in the camp, Doctors Without Borders/Médecins Sans Frontières (MSF) teams have witnessed the unsanitary conditions in which people are being held and are increasing medical humanitarian activities accordingly. The MPP, initially implemented in January 2019, requires people applying for asylum in the US to wait out their legal proceedings in Mexico. 

“We have a team with a doctor, psychologists and social workers who treat issues such as anxiety and post-traumatic stress disorder—consequences of the hopelessness produced by the uncertainty of not knowing what is going to happen with their future or their family,” said Anneli Droste, project coordinator for MSF Mexico's northern border project. 

In the last three weeks, MSF has also conducted 178 medical consultations for ailments including diarrhea, hypertension, diabetes, psychiatric conditions, and asthma. Most of the patients exhibited respiratory and skin and soft tissue conditions related to the overcrowded and unsanitary living conditions in the camp. Of these consultations, 48 percent were for women and 52 percent were for men. More than half were under 15 years old (58 percent).  

Droste said that she recently spoke with a 15-year-old boy living in the camp with his family while waiting for a decision on their asylum claim. “He told me that they don’t want to be separated from the asylum seekers’ group, because they fear assault or kidnapping,” Droste said. “Staying together is one of the measures they have taken to feel, in some way, protected.” 

MSF remains gravely concerned about the humanitarian needs of asylum seekers along Mexico’s northern border and demands, once again, that the Mexican and US governments protect their lives and well-being.

WHO gravely concerned about humanitarian situation in northeast Syria

By email, a statement from WHO:

13 October, Cairo, Egypt — WHO is gravely concerned about the humanitarian health situation in northeast Syria, where up to 200,000 people have been displaced as a result of increased military operations since 9 October, and almost 1.5 million people are in need of health aid. Many of those affected by the recent hostilities have already experienced immense physical and mental stress as a result of years of conflict and repeated displacement.

People in need of essential health care services face challenges related to insecurity and limited access to health care. Already weakened health services in northeast Syria have been severely impacted by the latest security developments. The national hospital in Ras Al-Ain is currently out of service, and the national hospital and two health centers in Tel Abyad are also currently non-functional. The three field hospitals in Al-Hol camp have limited their services since 12 October as a result of the escalation of hostilities which has impeded access of health staff to the camp. All health facilities in camps hosting displaced people in Ain Issa and Ras al Ain have also been evacuated, with additional facilities under threat as the conflict rapidly escalates.

A number of health partners have already suspended services due to insecurity, further disrupting access to essential health care services. On 12 October, a trauma stabilization point located south of Ras Al Ain was evacuated after being reportedly attacked, resulting in two health staff injured and two ambulances destroyed. On the same day, the hospital in Ras Al-Ain was also reportedly attacked. There were no casualties as the facility had already been evacuated.

Across northeast Syria, shortages of health workers is widespread as they too have been among those displaced by the ongoing insecurity, aggravating an already critical situation and further depriving underserved populations of access to medical care.

Damages to the pumping station in Ras Al Ain, the main water source for most of Al Hassakeh governorate, has increased the risk of outbreaks of infectious diseases. Even before the current escalation in conflict, acute diarreah and typhoid were two of the most reported diseases among people in northeast Syria in August 2019. Ongoing displacements, overcrowded living conditions, and limited access to safe water and sanitation services, will likely lead to an increase in the number of people affected by water-borne diseases.

Amid this chaotic and fast-moving situation, WHO and health partners are working hard to respond to urgent health needs. Almost 314,000 medical treatments, vaccines, in addition to trauma medicines for 500 trauma patients have already been prepositioned in Qamishly hub. An additional shipment of more than 100,000 treatments and medicines for 640 trauma patients will be airlifted to Qamishly in the coming week. Medicines for diarrheal diseases, have also been prepositioned for delivery to health facilities as needed. Despite the challenges, many health NGOs continue to operate or shift to new locations. Some casualty cases requiring hospitalization are referred to a WHO-supported facility in Al-Hassakeh, and WHO is in the process of contracting two additional hospitals in Al-Hassakeh and Al-Raqqa to support referral services.

As the situation evolves, WHO and partners will continue to assess health needs and scale up their response as needed.

WHO calls on all parties to the conflict to preserve the right to health for hundreds of thousands of innocent civilians in northeast Syria, and comply with International Humanitarian Law to protect all civilians, including health care workers and patients, as well as health facilities.

MSF: Urgent humanitarian response needed to unprecedented crises in northeast DR Congo

MSF.org has published Urgent humanitarian response needed to unprecedented crises in northeast Democratic Republic of Congo.

KISANGANI/GENEVA – Multiple humanitarian crises are unfolding in Ituri province, northeastern Democratic Republic of Congo, and hundreds of thousands of people are in urgent need of humanitarian assistance, according to Médecins Sans Frontières (MSF). 

The recent upsurge in violence across the regions of Djugu, Mahagi and Irumu have forced thousands to flee their homes. Despite MSF’s repeated calls on international aid organisations to scale up humanitarian aid, the majority of the displaced still haven’t received even the most basic assistance.

“Unfortunately, this is not the first time there are important humanitarian needs in the country,” explains Dr Moussa Ousman, MSF Head of Mission in the Democratic Republic of Congo. “This time we are seeing not only mass displacement due to violence but also a rapidly spreading measles outbreak and an Ebola epidemic that shows no signs of slowing down, all at the same time. This is unprecedented.”

Intercommunal violence has been increasing in Ituri since December 2017, and the large majority of people displaced as a result have been in urgent need of humanitarian assistance, some for more than a year. Since October 2018, MSF has conducted three mortality surveys in the locations of Drodro, Nizi and Angumu. All showed that the mortality rates in these communities were far above emergency levels. 

“Our surveys show that people are mainly dying from preventable diseases such as malaria, measles and diarrhoea,” says Dr Ousman. “That is very worrying. Especially as it has not yet been possible to vaccinate against measles because of the ongoing Ebola outbreak, and the fear of Ebola further spreading. Together with the ministry of health, we are looking at what innovative strategies we can implement given the circumstances, but more help is urgently needed here to prevent more deaths.”

MSF is supporting the local ministry of health to provide medical care and respond to the most acute needs of the displaced in Drodro, Nizi and Bunia. Our teams are also providing clean water, distributing relief items and constructing showers and latrines. Nevertheless, the most urgent needs of thousands of families remain unmet. 

MSF urges for an immediate scale up of long-term humanitarian assistance, to prevent the loss of more lives and to ensure decent living conditions for all those who have been forced to flee.

OCHA in Mozambique: Cyclone Idai & Floods Flash Update No. 11, 27 March 2019

Via ReliefWeb, an OCHA report: Mozambique: Cyclone Idai & Floods Flash Update No. 11, 27 March 2019. Excerpt:

HIGHLIGHTS 

• On 27 March, the Government confirmed five cases of cholera at the Munhava health centre in the city of Beira and some 2,500 cases of acute watery diarrhoea in Beira district.  

• A humanitarian assessment team identified nearly 1,500 people unreached people in need of support in Matarara in Chimoio district. Food drops were carried out to provide immediate assistance and follow-up is ongoing. 

• Nearly 136,000 people were accommodated in 161 sites across Sofala (119 sites), Manica (27 sites), Zambezia (11 sites) and Tete (4 sites) as of 27 March; an increase of more than 9,200 people from 26 March. 

• More than 92,000 houses were identified as totally destroyed (50,772), partially destroyed (25,769) or flooded (15,784) as of 27 March; an increase of more than 1,300 since 26 March. 

• Health partners have raised concern over menstrual hygiene as most girls and women in IDP accommodation sites reportedly do not have access to clean water and safe spaces to hang sanitary materials. 

SITUATION OVERVIEW 

On 27 March, the Government confirmed five cases of cholera at Munhava health centre in Beira City, according to the National Director of Medical Assistance, Ussene Isse. The authorities also reported some 2,500 cases of acute watery diarrhoea (AWD) in Beira district. A total of 900,000 cholera vaccine doses, which will be effective for six months, are expected to arrive in Mozambique by 1 April and micro-planning for the vaccination campaign is underway. 

The number of internally displaced people (IDPs) accommodated in 161 sites across Sofala (119 sites), Manica (27 sites), Zambezia (11 sites) and Tete (4 sites) has risen by more than 9,200 people, to nearly 136,000 people, as of 27 March. More than 92,000 houses were identified as totally destroyed (50,772), partially destroyed (25,769) or flooded (15,784) as of 27 March; an increase of more than 1,300 since 26 March. 

More than 3,200 schools were destroyed and nearly 91,000 students are affected, including those whose schools are being used as accommodation sites. The Ministry of Education is preparing a timeline to address the forced break in schooling as the authorities work on transferring IDPs from schools into new accommodation sites to allow schools to reopen. 

An assessment team identified nearly 1,500 people in Pambanisa, Matarara, in Chimoio district, in urgent need of assistance. A food drop to last three days was carried out to assist them immediately and response is ongoing. An airdrop of shelter kits by helicopter is scheduled. 

In Dombe, health centres are reportedly out of medical supplies and essential medicines and most are running without electricity. A private company has set-up a generator for the hospital in Sussungenga district, which is now fully operational. 

Water supply has reportedly been reestablished in Beira, with 60 per cent of the pipes in the city having running water, according to WASH partners. A special water trucking operation is being run by the Government pending the repair of all damaged infrastructure. UK aid flights reportedly transported materials for the repair of the water systems in Beira, while WASH partners have provided technical support, fuel and water treatment chemicals for the systems.

Disappearance of some dirty hand diseases among the positive effects of Ebola in MANGINA

Via Radio Moto Butembo-Beni: Disappearance of some dirty hand diseases among the positive effects of Ebola in MANGINA. The Google translation:

Several so-called dirty hand diseases no longer exist in Mangina commune located in the health zone of Mabalako, since the appearance of the Ebola virus disease. Finding local health care staff. And the civil society of Mangina commune encourages people to wash their hands regularly, even after Ebola. 

For nearly 8 months, waterborne diseases have not been registered in several health facilities in Mangina. According to a medical staff on Wednesday, March 27, hand washing has greatly influenced the reduction of diseases such as cholera, typhoid and others. This health specialist is encouraging people to keep this good practice after Ebola. 

In its communication to the press, Mangina's core civil society had asked the population not to dodge some entry points to avoid hand-washing.  

"Washing your hands is an exercise every day. This is not to say that it is because of the teams of the response that ask us to wash our hands that we will boycott. So everyone is called not to dodge the entry points. When you wash your hands, you save yourself from diseases of dirty hands. It's not just Ebola. There is also diarrhea, cholera ... be really  consistent," said Freddy MBAYAHI, vice president and spokesperson of civil society.

WHO EMRO: Resurgence of cholera, AWD in Yemen

Via WHO EMRO, a report from Geert Cappelaere, UNICEF Regional Director in the Middle East and North Africa and Dr Ahmed Al Mandhari, WHO Regional Director for the Eastern Mediterranean: Two years since world-largest outbreak of acute watery diarrhoea and cholera, Yemen witnessing another sharp increase in reported cases with number of deaths continuing to increase.

MUSCAT/ AMMAN/CAIRO, 26 March 2019 – “In Yemen, since the beginning of the year until 17 March, nearly 109 000 cases of severe acute watery diarrhoea and suspected cholera were reported with 190 total associated deaths since January. Nearly one third of the reported cases are children under the age of 5. This comes 2 years since Yemen witnessed the world-largest outbreak when more than 1 million cases were reported. 

“We fear that the number of suspected cholera cases will continue to increase with the early arrival of the rainy season and as basic services, including lifesaving water systems and networks have collapsed. The situation is exacerbated by the poor status of sewage disposal systems, the use of contaminated water for agriculture, unreliable electricity to store food and families’ displacement as they flee escalating violence especially in Hudaydah and Tai’z.  

“Our teams in Yemen are working day and night with a wide network of local partners to respond and stop the further spread and transmission of the diseases. Focusing on 147 priority districts, additional health, water, hygiene and sanitation supplies are being mobilized. Rapid response teams have been deployed. A total of 413 diarrhoea treatment centres and oral rehydration centres are operational in all 147 priority districts. 

"Partners are repairing water and sanitation systems. In the past weeks, we scaled up chlorination activities to disinfect water in 95 priority districts and provided fuel and spare parts to keep going water supply and sanitation networks. A round of oral cholera vaccine campaign reached over 400 000 people in several districts. 

"Meanwhile, community-based awareness raising reached 600 000 people in house-to-house campaigns since early 2019 to provide families with hygiene practices and improve reporting symptoms and seeking treatment.  

“UNICEF and WHO are committed to continue scaling up the response to assist immediately the people affected and to prevent the disease from spreading further. We are doing everything possible to avoid the 2017 scenario including the timely use of proven effective measures, including oral cholera vaccination. However, we face several challenges, including the intensification of fighting, access restrictions and bureaucratic hurdles to bring lifesaving supplies and personnel to Yemen.  

“UNICEF and WHO are calling to lift all restrictions on our humanitarian operations to respond to the spread of the disease and other areas. Our humanitarian teams must have full access to reach every child, every woman, every man in need of medical and other humanitarian assistance. 

“Above all, we jointly reiterate the calls for the fighting to end. It is time for the 4-year long war to come to an end. If not, Yemen will continue to be trapped in a web of diseases, malice and sink deeper in endless humanitarian disasters, with the most vulnerable paying the highest price.

Canadian Red Cross sends team of health workers to Mozambique amid humanitarian crisis

Via The Globe and Mail, Geoffrey York writes: Canadian Red Cross sends team of health workers to Mozambique amid humanitarian crisis. Excerp:

The Canadian Red Cross is sending an emergency field hospital and a team of 25 Canadian health workers to battle a growing humanitarian crisis in Mozambique after a devastating cyclone. 

There are fears of cholera outbreaks and rising malaria infections from the massive flooding in the wake of Cyclone Idai. Stagnant water stretches across 3,000 square kilometres of the country. Several hundred thousand people have lost their homes in the biggest humanitarian disaster in Mozambique’s recent history, and an estimated 1.8 million people need urgent aid, according to the United Nations. 

About 55 health centres in the country have been severely damaged, the World Health Organization said Tuesday. The WHO is sending 900,000 doses of cholera vaccines and 900,000 bed nets to Mozambique to prepare for an expected surge in cholera and malaria cases. Some cholera cases have already been reported.  

Senior UN officials have said the cyclone and flooding may have been the worst weather-related disaster ever to hit the southern hemisphere. The Red Cross has warned that the threat of water-borne diseases such as cholera and malaria is a “ticking bomb” for the region. 

The Canadian Red Cross field hospital, including 53,000 kilograms of medical supplies and three Land Cruisers for mobile health delivery, was flown out of Canada on a Boeing 747 cargo airplane Tuesday and will arrive in Mozambique on Wednesday, along with the 25 health workers and other aid workers. 

Their goal is to help restore medical care in a country where basic services have been drastically disrupted, many clinics do not have electricity and the threat of water-borne diseases is looming.  

“We want to prevent a second disaster from happening,” said Chiran Livera, operations manager at the Canadian Red Cross. 

Mozambique’s doctors and nurses have been working non-stop and are suffering a “tremendous strain,” the Red Cross said.

WHO: Cyclone Idai briefing

WHO has published a Cyclone Idai briefing by Dr. Djamila Cabral, WHO representative in Mozambique:

Last Friday I visited Beira, one of the worst-affected areas that was hit by Tropical Cyclone Idai.  

The devastation is enormous 

More than 100 000 people have lost their homes and all of their possessions. Families, pregnant women, babies are living in temporary camps in horrific conditions, without secure food supplies, or safe drinking water and sanitation. 

Around 55 health centres have been severely damaged. I visited the central hospital in Beira where I saw the direct impact of the cyclone. The flooding had damaged essential equipment and the facility is unable to receive patients during this crucial time. As an example, surgical theatre and nursery completely damaged.  

Official death toll is more than 446 but we expect the real numbers to be much higher. 1.8 million people in Mozambique need urgent humanitarian assistance. 

For WHO, health is our number one priority now 

We must not let these people suffer a second disaster through a serious disease outbreak or inability to access essential health services. They have suffered enough. 

WHO’s Director General, Dr Tedros has called for a "no regrets" approach - this means that we are doing whatever it takes to address the crisis, investing all the available resources now to save lives and protect health.  

We are building up a surge team of over 40 staff from across the Organization, with expertise in logistics, epidemiology, and outbreak prevention and response. 

We have a number of key priorities right now. First to set up an early warning disease detection system so that we can respond rapidly as soon as an outbreak is suspected. Then we need to ensure that, as resources come in, they are immediately put to work.  

There is increased risk of diseases 

We know that after an event like this, there is extremely high risk of diarrhoeal diseases like cholera. WHO is positioning supplies to prepare to treat diarrhoeal diseases – lifesaving intravenous fluids, diagnostic tests, 900 000 doses of oral cholera vaccines are on their way from the global emergency stockpile. We are providing our expertise to set up 3 cholera treatment centres, including an 80-bed treatment centre in Beira.  

We are also preparing for a spike in malaria in the coming weeks by procuring 900 000 insecticide-treated bednets to protect all affected families, and ensure rapid diagnostic tests and antimalarials are positioned to high-risk areas.  

And we are working at top speed to ensure that the people of Mozambique can access essential health services during this crisis to ensure that:  

• people with HIV, TB or diabetes continue to receive their medications 

• thousands of pregnant women are able to receive care for safe childbirth 

• children receive treatment for common infections and are screened (and treated if needed) for acute malnutrition

 • people in need receive psycho-social support and protection from gender-based violence. 

The coming weeks are crucial for WHO in Mozambique. The health sector needs at least $38 million over the next 3 months for the health response to this humanitarian crisis.

Mozambique: Cyclone Idai & Floods Flash Update No. 9, 25 March 2019

Via ReliefWeb, an OCHA report: Mozambique: Cyclone Idai & Floods Flash Update No. 9, 25 March 2019. Excerpt:

HIGHLIGHTS 

• The official death toll was 447 people as of 25 March, according to the Government. 

• Nearly 129,000 people are sheltering in 143 collective sites across Sofala (more than 97,600 people), Manica (more than 14,800 people); Zambezia (more than 9,600 people); and Tete (more than 6,800 people).  

• The entire District of Nhamatanda in Sofala Province has been affected by Cyclone Idai and related floods, and nearly 15,000 people are sheltering in 14 sites across the district.  

SITUATION OVERVIEW 

As of 25 March, the official death toll was 447, with more than 1,500 people injured, according to the Government. 

Authorities and aid agencies have highlighted the need for increased support in the management of dead bodies across the affected districts, as mortuary services are reportedly constrained. Nearly 129,000 people were accommodated in 143 sites across Sofala (103 sites), Manica (26 sites), Zambezia (10 sites) and Tete (4 sites), as of 25 March, an increase of more than 20,200 people since 24 March, across the affected areas. Some 72,260 houses are reportedly totally destroyed (36,747), partially destroyed (19,733) or flooded (2,184), with more than 497,700 hectares of crops damaged. 

Reports of acute watery diarrhoea cases are increasing in areas impacted by the cyclone and floods, although the exact number of cases is yet to be confirmed. Health partners are in the process of identifying suitable locations for the establishment of treatment centers and it is expected that the figures of those infected will become clearer as people report to the centres. Key messages on the signs and symptoms of diarrhoea, when and where to seek help, prevention and general hygiene are being conveyed on local radio with the support of the Community Engagement Group.  

On 23 and 24 March, a joint government-led multi-agency rapid needs assessment was conducted in Donbe, Matara and Sussundega, in Chimioi District, Manica Province. More than 13,300 people affected by Cyclone Idai and floods were identified in six locations: Chimoio, Gondala, Macate, Matarara, Sussundega and Vanduzi. The number of deaths in the district is reportedly rising, as the flood waters recede, with nine bodies found in Donbe this week. Efforts are underway to improve management of dead bodies, as mortuary facilities were either destroyed and/lack enough facilities and capacity. 

Priority needs in the affected parts of the district are food, with specific requests for cereals, vegetables, oil, salt, and biscuits, and non-food items, including kitchen sets, blankets, plastic sheeting and mosquito nets. 

The Provincial Governor has reportedly expressed concern over the potential for an outbreak of various water and vector-borne diseases, due to the challenging sanitation conditions and limited access to clean drinking water in the accommodation sites and surrounding areas. The Department of Health is planning to increase hygiene promotion activities, while Public Works Department will review the status of water provision in the shelters.

No food, no shelter, no livelihood: Families in Mozambique hit by Cyclone Idai

Via The Guardian: No food, no shelter, no livelihood: families in Mozambique hit by Cyclone Idai. Excerpt:

Beneath the crumbling arcade of the municipal council building in Beira, in Mozambique, a group of families has set up a dismal camp. They sleep on dirty concrete pavement and cook with branches from the trees brought down by Cyclone Idai which swept through southern Africa last week. 

Winds of more than 100mph triggered devastating floods and more than 400 people were killed, according to government sources. Land and environment minister Celso Correia said that the situation in the country was now critical. 

Laila Jorge, a mother of three, was one of those caught by the storm. A street vendor of alcoholic drinks, she was living in Zona B, a poor area of the port city of Beira, where shacks were once located close to the sea. “When the wind came, it took off the roof and blew down the wooden walls of my house. We had to run because we thought that we were going to die. There was waist-deep water [from the storm surge] in the street, so we ran here. We didn’t have our shoes and our feet got cut from glass we couldn’t see. We stopped when we got here because it was dry and because it was empty.” 

Jorge and the others have lost everything, she added. Her pots and flipflops were donated by workers cleaning up the damage and who took pity on them. Apart from that, they have received no aid.  

Near Jorge, several children are gathering water in large plastic bottles from a deep puddle that has overflowed from the fountain pool in the square opposite. Next to them, a boy of about eight is washing tiny sprat-like fish that glisten in a pot. Jorge said the fish were washed up by the cyclone and stranded in the pools of standing water left in the city and were now being collected by local boys. “Dead or alive, we’ve been eating them,” she said, “because it’s all we have to eat.” 

Jorge said dirty water being scooped up and carried by the children from the square was for cooking and washing, not drinking, but added that her children aged three, five and seven all had diarrhoea. 

Despite a huge global-aid appeal that has raised tens of millions across the world, including in the UK, many like Jorge have yet to see assistance. For their part, international aid officials have admitted they were initially blindsided by the nature of the catastrophe. They had focused their initial efforts on Beira, which the Red Cross initially thought was largely destroyed by the cyclone. They did not foresee the arrival of devastating floods that would hit huge areas of the countryside more than a day later.

That wrongfooting had consequences. Badly needed helicopters, required to rescue people in the countryside sheltering in trees, on roofs and in electric pylons, were slow to arrive. “We could see from our first aerial surveys that Beira had been badly hit,” Jamie LeSueur of the Red Cross told the Observer. “What we weren’t able to predict was the scale of the flooding that would follow.”  

Even now officials admit they have yet to get a full picture of the scale of the disaster. They merely describe it as “overwhelming”.